Clinical observation of mitomycin and 5-fluorouracil with adjustable sutural trabeculectomy for glaucoma

• Main Authors: Xiao-Li Chen, Li Bin, Zhi-Ke Xu
• Format: Article
• Language: English
• Published: Press of International Journal of Ophthalmology (IJO PRESS) 2018-10-01
• Series: Guoji Yanke Zazhi
• Subjects: glaucoma; adjustable suture; trabeculectomy; mytomycin C; 5-fluorouracil; prognosis
• Online Access: http://ies.ijo.cn/cn_publish/2018/10/201810037.pdf

AIM: To take a contrastive analysis of glaucoma patients' clinical prognosis and complications after the usage of mitomycin(MMC)or 5-fluorouracil(5-FU)combined with adjustable sutural trabeculectomy. <p>METHODS: Retrospective case series reseach was undertaken. We divided the 71 cases(including primary open angle glaucoma and primary chronic angle-closure glaucoma)into two groups: MMC group(36 cases)and 5-FU group(35 cases). Both were treated with combined adjustable sutural trabeculectomy with the usage of MMC or 5-FU anti-cicatricial treatment, and followed up to compare intraocular pressure, filtered bubble form and complications. <p>RESULTS: The intraocular pressure of MMC group was lower than 5-FU group with statistical significance(<i>P</i><0.05); there was no significant difference in total surgical success rate between groups(<i>P</i>>0.05). Functional filtering bleb formation rate in MMC group was higher than 5-FU group while the formation rate of nonfunctional filtering bleb in MMC group was lower than 5-FU group(<i>P</i><0.05), which showed no significant difference in complication rate between groups(<i>P</i>>0.05), but the types of complications were different. <p>CONCLUSION: Both MMC and 5-FU can improve the success rate of glaucoma trabeculectomy as anti-cicatricial drugs. MMC can lower the intraocular pressure, is superior to 5-FU in the formation of functional filtering bleb. There was no significant difference in the incidence of complications between MMC and 5-FU according to personalized surgical protocols based on patients. When 5-FU is used, it is necessary to separate the filtering blebs repeatedly after operation and to reinject 5-FU under conjunctiva.